Concerns Spread as New Saudi MERS Cases Spike

Some Saudi ambulance crews refused to transport suspected victims, while drugstores are fast selling out of protective face masks – as the toll of a lethal new viral disease continues its steep month-long climb in Saudi Arabia.

As angry complaints soared, Saudi health officials confirmed 42 new cases of the Middle East Respiratory Syndrome-Coronavirus, or MERS-CoV, in the kingdom over the last week, seven of them fatal.

MERS globally took 1-½ years since its September 2012 discovery in the Middle East to reach its first 200 cases; last week alone, however, the cases jumped by about one-fourth. That includes, besides the new Saudi cases, another large cluster in the United Arab Emirates. The disease sickens mainly with respiratory infections.

Unusually persistent clusters in the Red Sea Saudi city of Jeddah, where many of the latest infected are health-care workers, have disease experts particularly concerned. Up to now the virus, which has camels as at least one of its hosts, has spread only in limited clusters person-to-person.

Without more data from Saudi Arabia, outside infectious-disease experts can only guess if the many Jeddah cases now represent repeated and serious breakdowns in infection control among health workers, said Ian M. Mackay, a virologist at the Australian Infectious Disease Research Center at the University of Queensland.

“Or else, are we seeing a changed variant of MERS-CoV – a virus that has changed and is capable of more efficient human-to-human transmission?” Mr. Mackay asked, in a question echoed by other outside disease experts this week.

There was some, limited good news. The fatality rate of MERS appears to have dropped about one-in-two cases at the time of the disease’s discovery to what Mr. Mackay said was one-in-three cases, possibly because health officials have stepped up testing for the virus.

And there was no word yet on the first two cases in Southeast Asia spreading from person-to-person there.

In Saudi Arabia, the surge in cases brought MERS squarely to the front of national attention. Health officials did not respond to calls and emails seeking comment Sunday.

The kingdom’s state news agency meanwhile announced Sunday that a team of experts from the World Health Organization, the United States and elsewhere would come at the end of the month to help, although it gave no details.

The kingdom also had made contact with an international pharmaceutical company about developing a vaccine, the state news agency said, again without giving details.

Health experts have said developing a human vaccine would be time-consuming and perhaps prohibitively expensive. Some have said developing a vaccine to inoculate camels against MERS could be more effective in the long run.

The Ministry of Health carried notices on Twitter and YouTube about hand-washing and other means of limiting the spread of the virus.

Over the weekend, the kingdom’s official Red Crescent health service announced that ambulance crews had no choice but carry suspected MERS cases.

That was after an audio recording circulated on social media of ambulance workers reportedly refusing to carry a man believed ill with MERS. “Just put a double layer of masks on,” the dispatcher told the workers, who stuck to their refusal.

On social media, doctors and nurses tweeted of growing numbers of colleagues sickened. Some accused the Health Ministry of concealing the true number of cases, and playing down the overall severity of the outbreak. “Health Minister: You have to at least declare an emergency…so it is possible to activate the protocols of infection,” one Jeddah doctor tweeted. “We don’t want to lose more souls.”

On Saturday, Saudi Arabia’s Okaz newspaper carried what it said was a notice from the Health Ministry threatening health workers with prison for disclosing any health ministry information. That followed a Cabinet order last week, directing Saudi news media to quote only official sources on the disease.

With the report of a gag order on Saudi health workers, “people are past fury, and looking for ways of protection,” one Jeddah woman said by email. Like many, she was tweeting advice to fellow Saudis at large on protective measures against MERS, and urging public reporting of any price-gouging on remaining supplies of face masks.